Iyer S P, Movva K, Wiebel M, Chandrasekar P, Alangaden G, Carron M, Tranchida P, Revankar S G
Department of Medicine, St. John's Medical Center, Detroit, Michigan, USA.
Transpl Infect Dis. 2013 Oct;15(5):E187-90. doi: 10.1111/tid.12128. Epub 2013 Aug 27.
Cryptococcal meningitis is a relatively common invasive fungal infection in immunocompromised patients, especially in solid organ transplant recipients. Clinical presentation typically includes fever, headache, photophobia, neck stiffness, and/or altered mental status. Unusual presentations may delay diagnosis. Therapy is challenging in renal transplant patients because of the nephrotoxicity associated with amphotericin B, the recommended treatment. We present a case of cryptococcal meningitis in a renal transplant recipient presenting as acute sinusitis with successful treatment using fluconazole as primary therapy.
隐球菌性脑膜炎是免疫功能低下患者中一种相对常见的侵袭性真菌感染，尤其是实体器官移植受者。临床表现通常包括发热、头痛、畏光、颈部僵硬和/或精神状态改变。不典型的表现可能会延迟诊断。由于推荐的治疗药物两性霉素B具有肾毒性，肾移植患者的治疗具有挑战性。我们报告一例肾移植受者隐球菌性脑膜炎，表现为急性鼻窦炎，以氟康唑作为主要治疗药物成功治愈。
